Cargando…
What influences practitioners’ readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework
BACKGROUND: Contemporary health policy is shifting towards remotely delivered care. A growing need to provide effective and accessible services, with maximal population reach has stimulated demand for flexible and efficient service models. The implementation of evidence-based practice has been slow,...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364130/ https://www.ncbi.nlm.nih.gov/pubmed/32677917 http://dx.doi.org/10.1186/s12888-020-02761-3 |
_version_ | 1783559778739421184 |
---|---|
author | Faija, Cintia L. Connell, Janice Welsh, Charlotte Ardern, Kerry Hopkin, Elinor Gellatly, Judith Rushton, Kelly Fraser, Claire Irvine, Annie Armitage, Christopher J. Wilson, Paul Bower, Peter Lovell, Karina Bee, Penny |
author_facet | Faija, Cintia L. Connell, Janice Welsh, Charlotte Ardern, Kerry Hopkin, Elinor Gellatly, Judith Rushton, Kelly Fraser, Claire Irvine, Annie Armitage, Christopher J. Wilson, Paul Bower, Peter Lovell, Karina Bee, Penny |
author_sort | Faija, Cintia L. |
collection | PubMed |
description | BACKGROUND: Contemporary health policy is shifting towards remotely delivered care. A growing need to provide effective and accessible services, with maximal population reach has stimulated demand for flexible and efficient service models. The implementation of evidence-based practice has been slow, leaving many services ill equipped to respond to requests for non-face-to-face delivery. To address this translation gap, and provide empirically derived evidence to support large-scale practice change, our study aimed to explore practitioners’ perspectives of the factors that enhance the delivery of a NICE-recommended psychological intervention, i.e. guided self-help by telephone (GSH-T), in routine care. We used the Theoretical Domains Framework (TDF) to analyse our data, identify essential behaviour change processes and encourage the successful implementation of remote working in clinical practice. METHOD: Thirty-four psychological wellbeing practitioners (PWPs) from the UK NHS Improving Access to Psychological Therapies (IAPT) services were interviewed. Data were first analysed inductively, with codes cross-matched deductively to the TDF. RESULTS: Analysis identified barriers to the delivery, engagement and implementation of GSH-T, within eight domains from the TDF: (i) Deficits in practitioner knowledge, (ii) Sub-optimal practitioner telephone skills, (iii) Practitioners’ lack of beliefs in telephone capabilities and self-confidence, (iv) Practitioners’ negative beliefs about consequences, (v) Negative emotions, (vi) Professional role expectations (vii) Negative social influences, and (viii) Challenges in the environmental context and resources. A degree of interdependence was observed between the TDF domains, such that improvements in one domain were often reported to confer secondary advantages in another. CONCLUSIONS: Multiple TDF domains emerge as relevant to improve delivery of GSH-T; and these domains are theoretically and practically interlinked. A multicomponent approach is recommended to facilitate the shift from in-person to telephone-based service delivery models, and prompt behaviour change at practitioner, patient and service levels. At a minimum, the development of practitioners’ telephone skills, an increase in clients’ awareness of telephone-based treatment, dilution of negative preconceptions about telephone treatment, and robust service level guidance and standards for implementation are required. This is the first study that provides clear direction on how to improve telephone delivery and optimise implementation, aligning with current mental health policy and service improvement. |
format | Online Article Text |
id | pubmed-7364130 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-73641302020-07-16 What influences practitioners’ readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework Faija, Cintia L. Connell, Janice Welsh, Charlotte Ardern, Kerry Hopkin, Elinor Gellatly, Judith Rushton, Kelly Fraser, Claire Irvine, Annie Armitage, Christopher J. Wilson, Paul Bower, Peter Lovell, Karina Bee, Penny BMC Psychiatry Research Article BACKGROUND: Contemporary health policy is shifting towards remotely delivered care. A growing need to provide effective and accessible services, with maximal population reach has stimulated demand for flexible and efficient service models. The implementation of evidence-based practice has been slow, leaving many services ill equipped to respond to requests for non-face-to-face delivery. To address this translation gap, and provide empirically derived evidence to support large-scale practice change, our study aimed to explore practitioners’ perspectives of the factors that enhance the delivery of a NICE-recommended psychological intervention, i.e. guided self-help by telephone (GSH-T), in routine care. We used the Theoretical Domains Framework (TDF) to analyse our data, identify essential behaviour change processes and encourage the successful implementation of remote working in clinical practice. METHOD: Thirty-four psychological wellbeing practitioners (PWPs) from the UK NHS Improving Access to Psychological Therapies (IAPT) services were interviewed. Data were first analysed inductively, with codes cross-matched deductively to the TDF. RESULTS: Analysis identified barriers to the delivery, engagement and implementation of GSH-T, within eight domains from the TDF: (i) Deficits in practitioner knowledge, (ii) Sub-optimal practitioner telephone skills, (iii) Practitioners’ lack of beliefs in telephone capabilities and self-confidence, (iv) Practitioners’ negative beliefs about consequences, (v) Negative emotions, (vi) Professional role expectations (vii) Negative social influences, and (viii) Challenges in the environmental context and resources. A degree of interdependence was observed between the TDF domains, such that improvements in one domain were often reported to confer secondary advantages in another. CONCLUSIONS: Multiple TDF domains emerge as relevant to improve delivery of GSH-T; and these domains are theoretically and practically interlinked. A multicomponent approach is recommended to facilitate the shift from in-person to telephone-based service delivery models, and prompt behaviour change at practitioner, patient and service levels. At a minimum, the development of practitioners’ telephone skills, an increase in clients’ awareness of telephone-based treatment, dilution of negative preconceptions about telephone treatment, and robust service level guidance and standards for implementation are required. This is the first study that provides clear direction on how to improve telephone delivery and optimise implementation, aligning with current mental health policy and service improvement. BioMed Central 2020-07-16 /pmc/articles/PMC7364130/ /pubmed/32677917 http://dx.doi.org/10.1186/s12888-020-02761-3 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Faija, Cintia L. Connell, Janice Welsh, Charlotte Ardern, Kerry Hopkin, Elinor Gellatly, Judith Rushton, Kelly Fraser, Claire Irvine, Annie Armitage, Christopher J. Wilson, Paul Bower, Peter Lovell, Karina Bee, Penny What influences practitioners’ readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework |
title | What influences practitioners’ readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework |
title_full | What influences practitioners’ readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework |
title_fullStr | What influences practitioners’ readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework |
title_full_unstemmed | What influences practitioners’ readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework |
title_short | What influences practitioners’ readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework |
title_sort | what influences practitioners’ readiness to deliver psychological interventions by telephone? a qualitative study of behaviour change using the theoretical domains framework |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364130/ https://www.ncbi.nlm.nih.gov/pubmed/32677917 http://dx.doi.org/10.1186/s12888-020-02761-3 |
work_keys_str_mv | AT faijacintial whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT connelljanice whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT welshcharlotte whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT ardernkerry whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT hopkinelinor whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT gellatlyjudith whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT rushtonkelly whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT fraserclaire whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT irvineannie whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT armitagechristopherj whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT wilsonpaul whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT bowerpeter whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT lovellkarina whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework AT beepenny whatinfluencespractitionersreadinesstodeliverpsychologicalinterventionsbytelephoneaqualitativestudyofbehaviourchangeusingthetheoreticaldomainsframework |